NEHA September 2024 Journal of Environmental Health

ADVANCEMENT OF THE PRACTICE

Open Access

 DIRECT FROM ATSDR

Public Health Assessment Course: A Modernized Training for In-Depth Instruction on Evaluating Health Impacts of Community Exposure to Hazardous Substances

CDR Michelle Dittrich, MPH, REHS, CP-FS

CDR Elizabeth Irvin, PhD

of products that could include health-based conclusions; public health recommenda- tions; and actions to reduce, prevent, or mitigate exposures. Since the early 1990s, ATSDR has con- ducted training to ensure a consistent approach in the evaluation of environmental data and the formulation of conclusions and recommendations. Before 2012, ATSDR held an annual, multiday, in-person Public Health Assessment Basic Course attended by ATSDR sta, ATSDR cooperative agreement partners, federal partners, and international partners. In addition to an overview of the PHA pro- cess, the course included a field practicum designed to mimic site visits and community engagement activities. Beginning in 2012, ATSDR transitioned to online modules and webinars for its PHA process training. ATSDR developed the eight- module online Public Health Assessment Training, along with several other training opportunities and resources. Over the last decade, science has evolved, new tools have been developed, and a new workforce has taken shape. ATSDR recognized the need to reimplement and modernize the in-person PHA training. Modernized Course To develop a modernized curriculum, ATSDR formed an internal work group. The work group was tasked with providing a critical review of prior course curriculums, partici- pating in internal and external focus groups to gather feedback on training needs, and developing recommendations for a modi- fied curriculum (Figure 2). The work group developed an advanced technical course cur- riculum that included case studies, ATSDR

Editor’s Note: As part of our continued e ort to highlight innovative approaches to improve the health and environment of communities, the Journal is pleased to publish regular columns from the Agency for Toxic Substances and Disease Registry (ATSDR) at the Centers for Disease Control and Prevention (CDC). ATSDR serves the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and diseases related to toxic substances. The purpose of this column is to inform readers of ATSDR’s activities and initiatives to better understand the relationship between exposure to hazardous substances in the environment, its impact on human health, and how to protect public health. The findings and conclusions in this column are those of the author(s) and do not necessarily represent the o‚cial position of CDC or ATSDR. CDR Michelle Dittrich is an environmental health scientist assigned to ATSDR in Region 2. CDR Elizabeth Irvin, PhD, is the director of the O‚ce of Community Health Hazard Assessment at ATSDR.

B ackground The Agency for Toxic Substances and Disease Registry (ATSDR) protects communities from harmful health eects related to exposure to natural and human- made hazardous substances. One way ATSDR accomplishes this mission is by conducting site-specific evaluations of potential expo- sures of communities living near hazardous waste sites or facilities. ATSDR may conduct public health assessment activities when: • an individual, community group, or other party submits a petition to ATSDR to inves- tigate a specific site or facility; •a site is proposed for inclusion on the National Priorities List; or

• other federal, state, or local agencies or tribal health departments ask ATSDR to get involved. ATSDR uses a standard procedure known as the public health assessment (PHA) process to determine if people living near a hazardous waste site are being exposed to toxic substances and if the exposure is harmful, along with what must be done to stop or reduce exposure. During the PHA process, ATSDR scientists or cooperative agreement partners work with interdisci- plinary teams to gather and review various types of data and information and perform a series of scientific evaluations (Figure 1). The evaluations can result in several types

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